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Liberio BM, Seedorf G, Soranno DE, Montford JR, Faubel SG, Hernandez A, Abman SH, Gien J. Acute kidney injury decreases pulmonary vascular growth and alveolarization in neonatal rat pups. Pediatr Res 2023; 94:1308-1316. [PMID: 37138027 DOI: 10.1038/s41390-023-02625-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/13/2023] [Accepted: 04/15/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is common in sick neonates and associated with poor pulmonary outcomes, however, the mechanisms responsible remain unknown. We present two novel neonatal rodent models of AKI to investigate the pulmonary effects of AKI. METHODS In rat pups, AKI was induced surgically via bilateral ischemia-reperfusion injury (bIRI) or pharmacologically using aristolochic acid (AA). AKI was confirmed with plasma blood urea nitrogen and creatinine measurements and kidney injury molecule-1 staining on renal immunohistochemistry. Lung morphometrics were quantified with radial alveolar count and mean linear intercept, and angiogenesis investigated by pulmonary vessel density (PVD) and vascular endothelial growth factor (VEGF) protein expression. For the surgical model, bIRI, sham, and non-surgical pups were compared. For the pharmacologic model, AA pups were compared to vehicle controls. RESULTS AKI occurred in bIRI and AA pups, and they demonstrated decreased alveolarization, PVD, and VEGF protein expression compared controls. Sham pups did not experience AKI, however, demonstrated decreased alveolarization, PVD, and VEGF protein expression compared to controls. CONCLUSION Pharmacologic AKI and surgery in neonatal rat pups, with or without AKI, decreased alveolarization and angiogenesis, producing a bronchopulmonary dysplasia phenotype. These models provide a framework for elucidating the relationship between AKI and adverse pulmonary outcomes. IMPACT There are no published neonatal rodent models investigating the pulmonary effects after neonatal acute kidney injury, despite known clinical associations. We present two novel neonatal rodent models of acute kidney injury to study the impact of acute kidney injury on the developing lung. We demonstrate the pulmonary effects of both ischemia-reperfusion injury and nephrotoxin-induced AKI on the developing lung, with decreased alveolarization and angiogenesis, mimicking the lung phenotype of bronchopulmonary dysplasia. Neonatal rodent models of acute kidney injury provide opportunities to study mechanisms of kidney-lung crosstalk and novel therapeutics in the context of acute kidney injury in a premature infant.
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Affiliation(s)
- Brianna M Liberio
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Gregory Seedorf
- Department of Pediatrics, Section of Pulmonary and Sleep Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Danielle E Soranno
- Department of Pediatrics, Division of Pediatric Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John R Montford
- Department of Medicine, Division of Renal Medicine and Hypertension, University of Colorado School of Medicine, Aurora, CO, USA
- Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Sarah G Faubel
- Department of Medicine, Division of Renal Medicine and Hypertension, University of Colorado School of Medicine, Aurora, CO, USA
| | - Andres Hernandez
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Steven H Abman
- Department of Pediatrics, Section of Pulmonary and Sleep Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jason Gien
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO, USA
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Chu YT, Chen BH, Chen HH, Lee JC, Kuo TJ, Chiu HC, Lu WH. Hypoxia-Induced Kidney Injury in Newborn Rats. TOXICS 2023; 11:260. [PMID: 36977025 PMCID: PMC10053593 DOI: 10.3390/toxics11030260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Exposure to hypoxia during the early postnatal period can have adverse effects on vital organs. Neonatal Sprague-Dawley rats housed in a hypoxic chamber were compared to those in a normoxic chamber from postnatal days 0 to 7. Arterial blood was collected to evaluate renal function and hypoxia. Kidney morphology and fibrosis were evaluated using staining methods and immunoblotting. In the kidneys of the hypoxic group, protein expressions of hypoxia-inducible factor-1 were higher than those in the normoxic group. Hypoxic rats had higher levels of hematocrit, serum creatinine, and lactate than normoxic rats. Body weight was reduced, and protein loss of kidney tissue was observed in hypoxic rats compared to normoxic rats. Histologically, hypoxic rats showed glomerular atrophy and tubular injury. Renal fibrosis with collagen fiber deposition was observed in the hypoxic group. The expression of nicotinamide adenine dinucleotide phosphate oxidases was enhanced in the kidneys of hypoxic rats. Proteins involved in apoptosis were upregulated in the kidneys of hypoxic rats. An increase in the expression of pro-inflammatory cytokines was also observed in the kidneys of hypoxic rats. Hypoxic kidney injury in neonatal rats was associated with oxidative stress, inflammation, apoptosis, and fibrosis.
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Affiliation(s)
- Yi-Ting Chu
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Bo-Hau Chen
- Department of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan 32551, Taiwan
| | - Hsin-Hung Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Jui-Chen Lee
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Tzu-Jiun Kuo
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Hsiang-Chin Chiu
- Department of Pediatrics, Pingtung Veterans General Hospital, Pingtung 91245, Taiwan
| | - Wen-Hsien Lu
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
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3
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Hong H, Hosomichi J, Maeda H, Lekvijittada K, Oishi S, Ishida Y, Usumi-Fujita R, Kaneko S, Suzuki JI, Yoshida KI, Ono T. Intermittent hypoxia retards mandibular growth and alters RANKL expression in adolescent and juvenile rats. Eur J Orthod 2021; 43:94-103. [PMID: 32219305 DOI: 10.1093/ejo/cjaa020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Chronic intermittent hypoxia (IH), a common state experienced in obstructive sleep apnoea (OSA), retards mandibular growth in adolescent rats. The aim of this study was to elucidate the differential effects of IH on mandibular growth in different growth stages. MATERIALS AND METHODS Three-week-old (juvenile stage) and 7-week-old (adolescent stage) male Sprague-Dawley rats underwent IH for 3 weeks. Age-matched control rats were exposed to room air. Mandibular growth was evaluated by radiograph analysis, micro-computed tomography, real-time polymerase chain reaction and immunohistology. Tibial growth was evaluated as an index of systemic skeletal growth. RESULTS IH had no significant impact on the general growth of either the juvenile or adolescent rats. However, it significantly decreased the total mandibular length and the posterior corpus length of the mandible in the adolescent rats and the anterior corpus length in the juvenile rats. IH also increased bone mineral density (BMD) of the condylar head in adolescent rats but did not affect the BMD of the tibia. Immunohistological analysis showed that the expression level of receptor activation of nuclear factor-κB ligand significantly decreased (in contrast to its messenger ribonucleicacid level) in the condylar head of adolescent rats with IH, while the number of osteoprotegerin-positive cells was comparable in the mandibles of adolescent IH rats and control rats. LIMITATIONS The animal model could not simulate the pathological conditions of OSA completely and there were differences in bone growth between humans and rodents. CONCLUSIONS These results suggest that the susceptibility of mandibular growth retardation to IH depends on the growth stage of the rats.
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Affiliation(s)
- Haixin Hong
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.,Department of Forensic Medicine, Graduate School of Medicine, Tokyo Medical University, Japan
| | - Jun Hosomichi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.,Department of Forensic Medicine, Graduate School of Medicine, Tokyo Medical University, Japan
| | - Hideyuki Maeda
- Department of Forensic Medicine, Graduate School of Medicine, Tokyo Medical University, Japan
| | - Kochakorn Lekvijittada
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.,Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Shuji Oishi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Yuji Ishida
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Risa Usumi-Fujita
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Sawa Kaneko
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Jun-Ichi Suzuki
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.,Department of Advanced Clinical Science and Therapeutics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Ken-Ichi Yoshida
- Department of Forensic Medicine, Graduate School of Medicine, Tokyo Medical University, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
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Fluid management, electrolytes imbalance and renal management in neonates with neonatal encephalopathy treated with hypothermia. Semin Fetal Neonatal Med 2021; 26:101261. [PMID: 34140246 DOI: 10.1016/j.siny.2021.101261] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Kidney dysfunction and acute kidney injury (AKI) frequently accompanies neonatal encephalopathy and contributes to neonatal morbidity and mortality. While there are currently no proven therapies for the treatment of AKI, understanding the pathophysiology along with early recognition and treatment of alterations in fluid, electrolyte and metabolic homeostasis that accompany AKI offer opportunity to reduce associated morbidity. Promising new tests and technologies, including urine and serum biomarkers and renal near-infrared spectroscopy offer opportunities to improve diagnosis and monitoring of neonates at risk for kidney injury. Furthermore, recent advances in neonatal kidney supportive therapies such as hemofiltration and hemodialysis may further improve outcomes in this population. This chapter provides an overview of disorders of fluid balance, electrolyte homeostasis and kidney function associated with neonatal encephalopathy and therapeutic hypothermia. Recommendations for fluid and electrolyte management based upon published literature and authors' opinions are provided.
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Pevzner IB, Pavlenko TA, Popkov VA, Andrianova NV, Zorova LD, Brezgunova AA, Zorov SD, Yankauskas SS, Silachev DN, Zorov DB, Plotnikov EY. Comparative Study of the Severity of Renal Damage in Newborn and Adult Rats under Conditions of Ischemia/Reperfusion and Endotoxin Administration. Bull Exp Biol Med 2018; 165:189-194. [PMID: 29923010 DOI: 10.1007/s10517-018-4127-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Indexed: 11/29/2022]
Abstract
Oxidative kidney injury was compared in newborn and adult rats under conditions of ischemia/reperfusion and in experimental model of systemic inflammation induced by endotoxin (LPS of bacterial cell wall) administration. Oxidative stress in the kidney accompanied both experimental models, but despite similar oxidative tissue damage, kidney dysfunction in neonates was less pronounced than in adult animals. It was found that neonatal kidney has a more potent regenerative potential with higher level of cell proliferation than adult kidney, where the level proliferating cell antigen (PCNA) increased only on day 2 after ischemia/reperfusion. The pathological process in the neonatal kidney developed against the background of active cell proliferation, and, as a result, proliferating cells could almost immediately replace the damaged structures. In the adult kidney, regeneration of the renal tissue was activated only after significant loss of functional nephrons and impairment of renal function.
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Affiliation(s)
- I B Pevzner
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia.,V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Moscow, Russia
| | - T A Pavlenko
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - V A Popkov
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - N V Andrianova
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - L D Zorova
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia.,V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Moscow, Russia
| | - A A Brezgunova
- Faculty of Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - S D Zorov
- Faculty of Bioengineering and Bioinformatics, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - S S Yankauskas
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - D N Silachev
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia.,V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Moscow, Russia
| | - D B Zorov
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia.,V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Moscow, Russia
| | - E Yu Plotnikov
- Institute of Molecular Medicine, I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia.
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Plotnikov EY, Pavlenko TA, Pevzner IB, Zorova LD, Manskikh VN, Silachev DN, Sukhikh GT, Zorov DB. The role of oxidative stress in acute renal injury of newborn rats exposed to hypoxia and endotoxin. FEBS J 2017; 284:3069-3078. [DOI: 10.1111/febs.14177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Egor Y. Plotnikov
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
| | - Tatiana A. Pavlenko
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- Russian Cardiology Research and Production Center; Moscow Russia
| | - Irina B. Pevzner
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
| | - Ljubava D. Zorova
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
- International Laser Center; M.V. Lomonosov Moscow State University; Russia
| | - Vasily N. Manskikh
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
| | - Denis N. Silachev
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
| | - Gennady T. Sukhikh
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
| | - Dmitry B. Zorov
- A.N. Belozersky Institute of Physico-Chemical Biology; M.V. Lomonosov Moscow State University; Russia
- V. I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology; Ministry of Health of the Russian Federation; Moscow Russia
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7
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Li Z, Langhans SA. Transcriptional regulators of Na,K-ATPase subunits. Front Cell Dev Biol 2015; 3:66. [PMID: 26579519 PMCID: PMC4620432 DOI: 10.3389/fcell.2015.00066] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 10/05/2015] [Indexed: 12/20/2022] Open
Abstract
The Na,K-ATPase classically serves as an ion pump creating an electrochemical gradient across the plasma membrane that is essential for transepithelial transport, nutrient uptake and membrane potential. In addition, Na,K-ATPase also functions as a receptor, a signal transducer and a cell adhesion molecule. With such diverse roles, it is understandable that the Na,K-ATPase subunits, the catalytic α-subunit, the β-subunit and the FXYD proteins, are controlled extensively during development and to accommodate physiological needs. The spatial and temporal expression of Na,K-ATPase is partially regulated at the transcriptional level. Numerous transcription factors, hormones, growth factors, lipids, and extracellular stimuli modulate the transcription of the Na,K-ATPase subunits. Moreover, epigenetic mechanisms also contribute to the regulation of Na,K-ATPase expression. With the ever growing knowledge about diseases associated with the malfunction of Na,K-ATPase, this review aims at summarizing the best-characterized transcription regulators that modulate Na,K-ATPase subunit levels. As abnormal expression of Na,K-ATPase subunits has been observed in many carcinoma, we will also discuss transcription factors that are associated with epithelial-mesenchymal transition, a crucial step in the progression of many tumors to malignant disease.
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Affiliation(s)
- Zhiqin Li
- Nemours Center for Childhood Cancer Research, Nemours/Alfred I. duPont Hospital for Children Wilmington, DE, USA
| | - Sigrid A Langhans
- Nemours Center for Childhood Cancer Research, Nemours/Alfred I. duPont Hospital for Children Wilmington, DE, USA
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Maruwaka M, Yoshikawa K, Okamoto S, Araki Y, Sumitomo M, Kawamura A, Yokoyama K, Wakabayashi T. Biomarker Research for Moyamoya Disease in Cerebrospinal Fluid Using Surface-enhanced Laser Desorption/Ionization Time-of-flight Mass Spectrometry. J Stroke Cerebrovasc Dis 2015; 24:104-11. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/28/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022] Open
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Abstract
The interruption of placental blood flow induces circulatory responses to maintain cerebral, cardiac, and adrenal blood flow with reduced renal, hepatic, intestinal, and skin blood flow. If placental compromise is prolonged and/or severe, total circulatory failure is likely with cerebral hypoperfusion and resultant hypoxic ischemic cerebral injury with collateral renal, cardiac, and hepatic injury. Management strategies should be targeted at restoring cerebral perfusion and oxygen delivery and minimizing the extent of secondary injury. Specifically, the focus should include the judicious use of supplemental oxygen, avoidance of hypoglycemia and elevated temperature in the delivery room, and the early administration of therapeutic hypothermia to high-risk infants.
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Affiliation(s)
- Jeffrey M Perlman
- Division of Newborn Medicine, Department of Pediatrics, Weill Cornell Medical College, 525 East 68th Street, Suite N-506, New York, NY 10065, USA.
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10
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Riordan M, Sreedharan R, Kashgarian M, Siegel NJ. Modulation of renal cell injury by heat shock proteins: lessons learned from the immature kidney. ACTA ACUST UNITED AC 2006; 2:149-56. [PMID: 16932413 DOI: 10.1038/ncpneph0117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Accepted: 12/23/2005] [Indexed: 01/29/2023]
Abstract
The mechanisms that underlie tolerance to injury in immature animals and tissues have been a subject of interest since 1670. Observations in neonatal units that premature infants are less prone to develop acute renal failure than adults in critical care units have prompted a series of investigations. Although initially attributed to metabolic adaptation such as increased glycolytic capacity and preservation of high energy phosphate, more recent studies have indicated a prominent role for the heat shock response. Observed modulations of injury by heat shock proteins in the immature kidney have significant implications for advancement of our understanding of renal cell injury in both adults and children.
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Affiliation(s)
- Michael Riordan
- Division of Pediatric Nephrology at Yale University School of Medicine, New Haven, CT 06520, USA
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11
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Oztürk H, Onen A, Oztürk H, Buyukbayram H. Exogenous human recombinant interleukin-10 protects the kidney against hypoxia-induced renal injury in immature rats. Int J Urol 2006; 13:397-400. [PMID: 16734858 DOI: 10.1111/j.1442-2042.2006.01304.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The purpose of this study was to determine the effects of exogenous human recombinant interleukin-10 (rhIL-10) on hypoxia-induced renal injury in immature rats. METHOD The study was performed on 1-day-old Sprague-Dawley rat pups. Group 1 (n = 8) served as non-hypoxic controls. Group 2 (untreated, n = 8) rats were subjected to hypoxia-reoxygenation (H/O) and were then returned to their mothers. Group 3 (rhIL-10 treated, n = 8) rats were subjected to H/O, were returned to their mothers, and were treated with rhIL-10 (75 microg/kg subcutaneously) for the next 3 days. All animals were killed on day 4 and renal specimens were obtained to determine the tissue level of malondialdehyde (MDA) and histological changes. RESULTS In the untreated group, moderate or severe renal tubular necrosis was observed However, the tubular necrosis score was significantly less in the rhIL-10 treated rats than in the untreated rats (P < 0.05). In the untreated group, MDA levels were significantly increased compared with the control and rhIL-10 groups (P < 0.001 and P < 0.05, respectively). In the rhIL-10 treated group, MDA levels were not significantly different compared with the control group. CONCLUSION RhIL-10 has a protective effect against hypoxia-induced renal injury in immature rats by depression of tissue MDA level and renal tubular necrosis score.
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Affiliation(s)
- Hayrettin Oztürk
- Department of Pediatric Surgery, Dicle University, Medical School, Diyarbakir, Turkey.
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12
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Vento M, Sastre J, Asensi MA, Viña J. Room-air resuscitation causes less damage to heart and kidney than 100% oxygen. Am J Respir Crit Care Med 2005; 172:1393-8. [PMID: 16141440 DOI: 10.1164/rccm.200412-1740oc] [Citation(s) in RCA: 203] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Pure oxygen causes more oxidative stress than room air in resuscitation of asphyctic neonates, and consequently could be associated with increased tissue damage. OBJECTIVES To compare damage caused to heart and kidneys on reoxygenation in severely asphyctic term neonates resuscitated with room air (RAR) or 100% oxygen (OxR). Nonasphyctic term newborn infants served as a control group. METHODS AND MEASUREMENTS This is a prospective randomized clinical trial masked for the gas mixture. Reduced glutathione (GSH), oxidized glutathione (GSSG), and superoxide dismutase (SOD) activity were measured to assess oxidative stress. Plasma cardiac troponin T (cTnT) and urinary N-acetyl-glucosaminidase (NAG) assessed cardiac and renal damage, respectively. Daily determinations of NAG for a 2-wk period were performed to monitor postasphyctic renal damage. MAIN RESULTS Both asphyctic groups showed oxidative stress when compared with the control group as evidenced by diminished GSH/GSSG ratios, adaptive increases in SOD activity, and higher values of NAG and cTnT (markers of tissue damage). However, the OxR group showed significantly higher values of NAG and cTnT, lower GSH/GSSG ratios, and higher SOD activity than the RAR group. Moreover, NAG values persisted in being higher than normal in the OxR group for 2 wk after birth, whereas NAG in the RAR group dropped to normal within the first week. A linear correlation between cTnT or NAG and GSSG was found. CONCLUSIONS The use of room air on resuscitation causes less oxidative stress and damage to heart and kidney than pure oxygen.
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Affiliation(s)
- Máximo Vento
- Neonatal Research Unit, Servicio de Neonatología, Hospital Universitario Materno-Infantil La Fe, Avenida de Campanar 21, 46009 Valencia, Spain.
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13
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Schmidt IM, Chellakooty M, Boisen KA, Damgaard IN, Mau Kai C, Olgaard K, Main KM. Impaired kidney growth in low-birth-weight children: Distinct effects of maturity and weight for gestational age. Kidney Int 2005; 68:731-40. [PMID: 16014050 DOI: 10.1111/j.1523-1755.2005.00451.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) alters the regulation of calcium and phosphate homeostasis, leading to secondary hyperparathyroidism, metabolic bone disease, soft tissue calcifications, and other metabolic derangements that have a significant impact on morbidity and mortality. The parathyroid gland is the central organ responsible for regulating these adaptive responses. Suppression of parathyroid hormone (PTH) secretion, hypertrophy, and hyperplasia are a major goal of treatment of CKD. METHODS Current literature was reviewed and combined with the author's experience to address a number of issues regarding the optimal treatment of secondary hyperparathyroidism in hemodialysis patients. RESULTS The calcium sensing receptor (CASR) is the most important factor regulating parathyroid gland function, and allosteric modulators of CASR, called calcimimetics, provide a novel drug therapy to suppress PTH secretion. The current use of active vitamin D analogues to suppress PTH is often limited by hypercalcemia and hyperphosphatemia. Clinical trials of cinacalcet HCl, the first calcimimetic to be approved for treatment of secondary hyperparathyroidism in CKD, have demonstrated suppression of circulating PTH levels without increments in the calcium-phosphorus (Ca x P) product, making it easier to achieve the stringent management guidelines proposed for subjects with CKD by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI). CONCLUSION The management of disordered calcium and phosphate homeostasis in CKD patients is evolving based on our knowledge of the major importance of the calcium sensing receptor (CASR) in controlling parathyroid gland function and the potent actions of calcimimetics to target CASR. The purpose of this presentation is to provide an overview of the role of the CASR in regulation of parathyroid gland function, to examine the mechanisms whereby calcimimetics target the CASR, and to review the clinical trials that support the use of cinacalcet HCl for the treatment of secondary hyperparathyroidism in stage 5 chronic kidney disease (CKD).
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Affiliation(s)
- Ida M Schmidt
- University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark.
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14
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Lampl M, Kuzawa CW, Jeanty P. Growth patterns of the heart and kidney suggest inter-organ collaboration in facultative fetal growth. Am J Hum Biol 2005; 17:178-94. [PMID: 15736176 DOI: 10.1002/ajhb.20109] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Maternal smoking during pregnancy has been associated with a number of negative sequelae among offspring, including elevated postnatal blood pressure. While animal studies have described organ level alterations with smoke exposure, human data have been more limited. Thirty-four healthy maternal/fetal pairs (24 nonsmokers, 10 smokers) participated in a longitudinal growth study from the thirteenth week of pregnancy to document fetal kidney and heart growth trajectories and morphology. Curve fitting followed by a mixed model for repeated measures identified significantly different growth patterns in kidney width, thickness, length, and volume growth with exposure: the smoke-exposed fetal kidney was wide and thick compared to the unexposed kidney during the second and early third trimester, declining to proportionately thin kidneys for length and width subsequently. Cardiac growth in width and volume followed a reverse pattern: a surge in cardiac volume occurred after 30 weeks with acceleration in cardiac width, resulting in a heart that was wide for length and for fetal weight. Smoke exposure altered fetal growth in size and timing of the heart and kidneys during midgestation, with changes in organ morphology suggesting compensatory growth. These are the first data providing anatomical evidence of altered renal/cardiac volume relationships that may provide a mechanism to previously reported sequelae of in utero smoke exposure. They suggest that cell-level adaptive responses to hypoxia and/or chemical insults are operative and illustrate the importance of longitudinal ultrasound to directly assess the organ-level growth response of the human fetus to a prenatal stress, in lieu of relying on birth outcome measures.
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Affiliation(s)
- Michelle Lampl
- Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, Georgia 30322, USA.
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